Nonpregnant Women Of Childbearing Age Research Articles

The Factors Affecting the Utilization of Tetanus Toxoid (TT) Immunization Program Services Among Prospective Brides in the City of Pematangsiantar

In 2023, there will be 454 prospective brides and grooms in the city of pematangsiantar with a total of 454 female brides and grooms. Based on Tetanus Toxoid (TT) immunization, in 2023 the target number of non-pregnant women of childbearing age is 43.333 with the number immunized being 351 with a percentage of 0,81%. This shows that Tetanus Toxoid (TT) immunization among women of childbearing age and prospective brides in Pematangsiantar City is still very low. The aim of this research is to determine the relationship between factors in the utilization of Tetanus Toxoid (TT) immunization program services among prospective brides in Pematangsiantar city. The type of research used is quantitative cross sectional design. The research was conducted in the city of pematangsiantar. The population was 454 female cats, the sample was 48 people, the sample was obtained using the lemeshow formula. Data analysis is univariate analysis and bivariate analysis (chi-square test) using the SPSS application. The result of the reseach show that variables related to Tetanus Toxoid (TT) immunization in prospective brides are Employment (p=0.311), Education Level (p=0.131), Knowledge (p=0.035), Attitude (p=0.031), Confidence in Health Services (p=0.933) and Ease of Information (p-value= 0.000). The most dominant variable related is ease of information. Conclusion in this study there are 3 factors related to the Tetanus Toxoid (TT) immunization program, namely Knowledge, Attitude and Ease of Information. The benefit of this research can be used as input in order to improve the quality of health service for the community.

Drug-Induced Liver Injury in Pregnancy: The U.S. Drug-Induced Liver Injury Network Experience.

There are limited data on the causative agents and characteristics of drug-induced liver injury in pregnant individuals. Data from patients with drug-induced liver injury enrolled in the ongoing multicenter Drug-Induced Liver Injury Network between 2004 and 2022 and occurring during pregnancy or 6 months postpartum were reviewed and compared with cases of drug-induced liver injury in nonpregnant women of childbearing age. Among 325 individuals of childbearing age in the Drug-Induced Liver Injury Network, 16 cases of drug-induced liver injury (5%) occurred during pregnancy or postpartum. Compared with drug-induced liver injury in nonpregnant women, pregnancy-related drug-induced liver injury was more severe ( P <.05). One elective termination and three miscarriages were documented; there were no maternal deaths. We recommend that isoniazid for latent tuberculosis be deferred to the postpartum period whenever feasible and that β-blockers or calcium channel blockers rather than methyldopa be used for hypertension management during pregnancy.

Folic acid supplementation in women of childbearing age with epilepsy: No association with type or number of antiepileptic drugs.

For over two decades, a daily folic acid (FA) supplementation has been recommended for women of childbearing age with epilepsy. This recommendation is based on evidence that FA administration before conception and during pregnancy can decrease the risk of fetal malformations in the general population, improve cognitive development, and reduce the risk of autistic traits in children exposed in utero to antiepileptic drugs (AEDs). The aim of this study was to evaluate FA supplementation rate in nonpregnant women of childbearing age with epilepsy and its relation to AED type and number. We retrospectively reviewed the computerized database and the medical records of all the women who had a first visit to our outpatient epilepsy clinic (Shamir-Assaf Harofeh Medical Center, Zerifin, Israel) during a 10-year period (2012-2021). Only 61 (22%) of 282 nonpregnant women of childbearing age with epilepsy treated with AEDs received FA supplementation. Ninety-two (33%) of the women were treated with AED polytherapy, and 41 (15%) received valproic acid in monotherapy or polytherapy. FA supplementation rate was higher in women aged ≤40 versus >40 (25% vs. 8.5%) (p = .004). No correlation was found between FA supplementation and AED type or number. FA supplementation rate was low and was unaffected by AED treatment. Patient and physician-targeted interventions should be implemented to increase FA prescription and patient adherence.

Racial and Ethnic Disparities in Patient Experience and Diabetes Self-Management Among Nonpregnant Women of Childbearing Age With Diabetes in the United States: A Scoping Review, 1990 to 2020

ObjectiveThis scoping review aimed to identify any empirical literature describing racial and ethnic disparities in patient experience and diabetes self-management among nonpregnant women (aged 18–49 years) of childbearing age with diabetes in the United States. MethodsThis scoping review followed the Arksey and O'Malley methodological framework. We used a comprehensive search strategy to identify articles published from 1990 to 2021 in PubMed, CINAHL, EMBASE, Web of Science, the Cochrane Library, and Proquest Digital Dissertation and Theses. Two independent reviewers used Covidence, a web-based review management software, to screen articles by title and abstract, and then by full-text articles based on inclusion and exclusion criteria. A third reviewer arbitrated any disagreements. ResultsOf the original 6,115 peer-reviewed studies identified, eight fit the eligibility criteria. In research on nonpregnant women of childbearing age in the United States, four studies investigated racial and ethnic disparities in patient experience, and seven of the eight eligible studies investigated racial and ethnic disparities in diabetes self-management outcomes. No eligible studies examining racial and ethnic variations in the association between patient experience and diabetes self-management were found. ConclusionsThis scoping review identified limited available studies examining racial and ethnic disparities in patient experience and diabetes self-management among nonpregnant women of childbearing age in the United States. Future studies should examine these relationships to fill the gap in research. These findings are relevant as the prevalence of diabetes is increasing worldwide and racially/ethnically minoritized women are disproportionately affected.

The Influence of Racial/Ethnic and Gender Concordance on Care Among Non-Pregnant Women of Childbearing Age with Diabetes Mellitus: an Analysis of the Medical Expenditure Panel Survey, 2010-2019.

This study examined associations between patient-provider race/ethnicity concordance and gender concordance on overall healthcare ratings, self-efficacy, and diabetes care monitoring in non-pregnant women of childbearing age with diabetes mellitus before and after adjusting for sociodemographic factors. We analyzed longitudinal data from the 2010-2019 Medical Expenditure Panel Survey. The sample was limited to non-pregnant women of childbearing age (18-45years) diagnosed with diabetes (unweighted n = 327; weighted n = 566,504). Bivariate analysis, logistic regression, and latent variable modeling were performed. Few racially minoritized women reported racial/ethnic and gender concordance with their healthcare provider. Only 2.9% of Hispanic women reported having a Hispanic provider and 12.1% of non-Hispanic Black women reported seeing a non-Hispanic Black provider compared to 81.1% of non-Hispanic White women who reported seeing a non-Hispanic White provider (p < .0001). Among Hispanic women, 15.3% reported seeing a female provider compared to 25.2% of non-Hispanic Black and 53.5% of non-Hispanic White women. Patient-provider race/ethnicity and gender concordance were not statistically significantly associated with overall healthcare ratings, self-efficacy, or diabetes care monitoring. This study revealed a large disparity in race/ethnicity and gender concordance among minority women of reproductive age with diabetes compared to their non-Hispanic White counterparts. There is a need for larger, more robust studies to examine the influence of provider and other healthcare characteristics on diabetes-related outcomes in this understudied population.

The clinical course of COVID-19 in pregnant and non-pregnant women

Aims: Pregnancy is a physiological condition that predisposes women to respiratory complications of viral infections thus, bringing the risk of developing more severe disease. The aim of this research was to elucidate the clinical course of COVID-19 in pregnant and non-pregnant women of childbearing age. Mortality rate, laboratory parameters, the occurence of cytokine storm in both groups and the response to treatment have been investigated.&#x0D; Methods: A total of 88 women of childbearing age with a diagnosis of COVID-19 disease has been retrospectively analyzed. Age, comorbidity, length of stay in the intensive care unit and treatment regimen of patients have been obtained from hospital database. Ferritin, IL-6, CRP, procalcitonin, D-dimer, urea, creatinine, GFR, ALT, AST, LDH, lymphocyte count, neutrophil count, white blood cell count were evaluated. Clinical response such as reduction in oxygen requirement and vasopressor utilization before and after treatment were examined&#x0D; Results: The rate of RT - PCR positive results were statistical significantly higher in pregnant women (p=0.003). The median WBC, lymphocyte and leukocyte values of the pregnant patients were higher (p=0.038, p=0.006 and p=0.035, respectively). The median hemoglobin, LDH and ferritin values of pregnant women were lower than those of non-pregnant individuals (p=0.032, p

Biofilm Formation and Aspartyl Proteinase Activity and Their Association with Azole Resistance Among Candida albicans Causing Vulvovaginal Candidiasis, Egypt.

Candida albicans (C. albicans) is a major cause of vulvovaginal candidiasis (VVC), a condition that is commonly treated with azole agents. Biofilm formation and aspartyl proteinase production are important virulence factors that could be linked to azole resistance in C. albicans impeding therapy. To find out the association of both factors with azole resistance among C. albicans isolated from VVC cases in Egyptian nonpregnant women of childbearing age. In a cross-sectional study, C. albicans was isolated from nonpregnant females diagnosed clinically as having VVC during a 1-year study period. Susceptibility to azole agents was tested using the disc diffusion method. Biofilm formation and aspartyl proteinase production were assessed phenotypically. Additionally, two biofilm-related genes (ALS1 and HWP1) and three proteinase genes (SAP2, SAP4, and SAP6) were screened for using polymerase chain reaction (PCR). Among 204 C. albicans isolates, azole resistance ratios were as follows: voriconazole (30.4%), itraconazole (17.6%), fluconazole (11.3%) and econazole (6.4%). Biofilm-producing capacity was detected in 63.2% of isolates, and 63.2% were proteinase producers. The frequencies of ALS1 and HWP1 were 69.6% and 74.5%, respectively, while SAP2, SAP4, and SAP6 were 69.2%, 88.7%, and 64.7%, respectively. Biofilm formation was significantly associated with azole resistance (P < 0.001 for each tested azole agent) as was proteinase production (P < 0.001 for fluconazole, voriconazole, and econazole resistance and P = 0.047 for itraconazole). Among nonpregnant Egyptian women of childbearing age, azole resistance in C. albicans causing VVC is significantly associated with biofilm formation and proteinase production. The development of new therapeutic agents that can target these factors is warranted.

Testing proximal, intermediate, and health outcomes of patient centered communication among non-pregnant women of childbearing age with diabetes mellitus: Findings from the Medical Expenditure Panel Survey 2012-2018

ObjectiveTo determine associations between patient-centered communication (PCC) and overall healthcare ratings, self-efficacy, and management adherence among reproductive-age women with diabetes within the framework of Epstein and Street's conceptual model. MethodsWe analyzed longitudinal data from the 2012–2018 Medical Expenditure Panel Survey. The sample included 493 non-pregnant women of childbearing age (18–45 years) with diabetes. Independent variables were domains of PCC (listening, explaining, respecting, spending time, giving instructions, among others). Dependent variables were overall healthcare ratings, self-efficacy, and management adherence. Crude and adjusted associations were evaluated. ResultsNon-pregnant women of childbearing age who reported that their provider always listened to them, explained things, showed respect, and spent enough time with them had greater odds of reporting high overall healthcare ratings. Those who reported their provider always listened to them and spent enough time with them had greater odds of reporting better diabetes care adherence than those whose health care providers did not. ConclusionFindings demonstrate that non-pregnant women of childbearing age who report having optimal PCC are more likely to adhere to their diabetes care regimen. InnovationThis is the first known study using a nationally representative sample of non-pregnant women of childbearing age to examine multiple layers of PCC.

Nutritional status and dietary diversity of pregnant and nonpregnant reproductive-age Rohingya women.

There are no data on the nutritional status and dietary diversity of the pregnant and nonpregnant reproductive-age Rohingya women who have recently shifted to the Bhasan Char Relocation Camp located on an island in the Bay of Bengal. A cross-sectional survey was conducted in November-December, 2021 to assess the nutritional status and evaluate the dietary diversity of two vulnerable groups of the forcibly displaced Rohingya population: nonpregnant reproductive-age women and pregnant mothers. Multivariable logistic regression was applied to identify the factors associated with nutritional impairments. Overall, 7.6% of the nonpregnant reproductive-age women were underweight (Body Mass Index [BMI] < 18.5 kg/m2), and nearly one-third of them had a BMI ≥ 25 kg/m2. However, 26.7% of the pregnant mothers were undernourished (BMI < 20.0 kg/m2) and almost one-fourth of them were either overweight or obese (BMI ≥ 25.0 kg/m2). The prevalence of thinness (Mid Upper Arm Circumference [MUAC] < 23 cm) was 34.5% among pregnant mothers, and 10.1% of them were severely thin (MUAC < 21 cm). The mean (±SD) of the Women's Dietary Diversity Score (WDDS) was 3.3 (±1.1) for nonpregnant reproductive-age women and 3.7 (±1.3) for pregnant mothers enrolled in this study. Overall, 63.8% of the nonpregnant women of childbearing age and 46% of the pregnant mothers had a low WDDS (WDDS < 4). The WDDS was found to be protective against thinness among nonpregnant reproductive-age women (AOR = 0.61; 95% CI = 0.37, 0.93; p-value = .03) and low BMI in pregnant mothers (AOR = 0.71; 95% CI = 0.55, 0.91; p-value = .01). The results of this survey will assist in early recognition of the nutritional demands, and act as a guide to planning nutrition-based programs among Rohingya reproductive-age women relocated to the Bhasan Char Island.

Renal Artery Aneurysm Rupture as a Dangerous Mimic of Ovarian Cyst Rupture: A Case Report

Introduction: Renal artery aneurysm rupture is a rare but morbid diagnosis, often requiring emergency surgery and nephrectomy. Clinical presentation can mimic more common pathology in non-pregnant women such as ruptured ovarian cyst. Case Report: We present a case of a woman with a prior history of ovarian cyst presenting with a ruptured renal artery aneurysm. Prompt computed tomography (CT) imaging revealed a left renal artery aneurysm rupture with hemoperitoneum and renal infarct. She underwent emergency laparotomy and nephrectomy and was ultimately discharged in good condition. Conclusion: While ovarian cyst rupture is the most common cause of spontaneous hemoperitoneum in non-pregnant women of childbearing age, renal artery aneurysm rupture should be considered and prompt CT imaging obtained, particularly in cases of hemodynamic instability, to ensure prompt treatment.

Patient Experience with Their Health Care Provider Among Non-Pregnant Women of Childbearing Age with Diabetes Mellitus by Race and Ethnicity in the United States.

The study objective was to investigate differences in patient experiences with health care providers among non-pregnant women of childbearing age with diabetes mellitus (DM) by race/ethnicity. This study used cross-sectional data from the 2012-2018 Medical Expenditure Panel Survey. The sample was limited to women of childbearing age (18-45 years) who have ever been told they had diabetes (n = 763; weighted n = 903,670). The key independent variable was race/ethnicity. The variables of interest included patient experiences with health care in the past 12 months: patient-provider communication (PPC); patient-provider racial/ethnic concordance; patient-provider gender concordance; and satisfaction. After adjusting for age, marital status, education, poverty level, health insurance, and perceived health status, non-Hispanic (NH) Black women had lower odds (adjusted odds ratio [aOR] = 0.04; 95% confidence interval [CI] = 0.01-0.11) of receiving care from a health care provider of the same race compared with NH white women. Similar results were found among Hispanic and NH women of other or multiple races. Hispanic women had lower odds (aOR = 0.18; 95% CI = 0.06-0.50) of seeing a health care provider of the same race/ethnicity compared with NH white women in adjusted models. There were no statistically significant differences in PPC, patient-provider gender concordance, and satisfaction with their health care provider among Hispanic, NH Black, or NH women of other or multiple races in comparison to NH White women. There is a need to improve PPC quality and satisfaction in this patient population. Patient-provider racial/ethnic discordance among women of color with DM is concerning given the existing diabetes-related disparities. More research on women with DM is needed to inform and improve patient experience and health outcomes.

Clinical Epidemiology of Mothers with COVID-19 Hospitalized in Ardabil Province

Background: Pregnancy and childbirth do not increase the risk of COVID-19 infection, but the clinical complications and worsening are more severe than in non-pregnant women. Objectives: The aim of this study was to determine the clinical epidemiology of mothers with COVID-19 hospitalized in Ardabil province. Methods: In this cross-sectional descriptive study, the medical records of 20193 women of childbearing age from March 2020 to August 20 were reviewed. Gestational age, cause of hospitalization, the trend of disease and pregnancy, and possible and non-obstetric complications were evaluated. Data were analyzed by using statistical tests in SPSS version 21. Results: In this study, 9942 childbirths were performed, of which 5965 cesarean sections, 3977 normal deliveries, 6990 preterm deliveries, and 72 women had stillbirths. Also, 73 (0.73%) pregnant women had early symptoms of COVID-19. The highest age range was 25 - 30 years, mostly in the first pregnancy (41.9%) and the third trimester of pregnancy (61.6%) and with symptoms of persistent dry cough, shortness of breath, fever, muscle pain, chills, decreased arterial oxygen saturation and they were dizzy. Among all infected mothers, 20.5% had a preterm delivery, and 8.2% had a stillbirth. 0.36% of mothers with symptoms and 0.46% of mothers were PCR positive Conclusions: Pregnant women do not show clinical periods, and the result is comparable to non-pregnant women of childbearing age when infected with SARS-CoV-2. 0.3% of pregnant mothers were infected, which is not a high rate. Complications of pregnancy, such as preterm delivery and IUFD, are more common in involved pregnant women.

Pregnancy outcomes in a malaria-exposed Malian cohort of women of child-bearing age.

[https://clinicaltrials.gov/], identifier [NCT0297 4608].

Adverse drug reactions in pregnant women: Do they differ from those in non-pregnant women of childbearing age?

Pharmacoepidemiological research in pregnant women has focused on adverse drug reactions for the course of pregnancy or for the unborn child, but little is known on the risks for the mother. We reported the results of a study that compared adverse drug reactions in pregnant women with non-pregnant women of childbearing age, and investigated whether which types of adverse reactions were more often reported in pregnant women and which drugs were more often involved. This study was carried out in the French pharmacovigilance database (BNPV). We compared adverse drug reactions reported between 1 January 2010 and 31 December 2019 in pregnant women with those reported in of non-pregnant women of childbearing age. We cross-matched each pregnant woman with three non-pregnant women of childbearing age according to geographic area, age and year the adverse reaction was reported. Data analysis revealed that serious adverse reactions were more frequently reported in pregnant women, including anaphylactic reactions. Other adverse reactions including tachycardia, hypotension and hepatic injury were also more frequent in pregnant women than in non-pregnant women of the same age. This could be explained by physiological changes in pregnancy that lead to greater sensitivity to certain adverse reactions. Some drugs, such as phloroglucinol, metoclopramide, iron, atosiban and nifedipine, were more frequently involved in adverse reactions in pregnant women. These drugs are specifically used during pregnancy, which may explain why they are over-represented in adverse reactions. This is the first comparative descriptive study on drug adverse reactions in pregnant women. Specific epidemiological and pharmacokinetic studies are necessary to confirm these results and better understand the differences observed to improve the monitoring of pregnant women exposed to certain drugs.

Acute coronary syndrome during pregnancy and postpartum in France: the nationwide CONCEPTION study

Cardiovascular diseases, including acute coronary syndromes, are the leading cause of maternal death in many developed countries. We assessed acute coronary syndrome incidences during pregnancy, peripartum, and postpartum periods. We also compared overall pregnancy (ie, covering all 3 periods) incidence with that found in nonpregnant women of childbearing age. All women aged between 15 and 49 years without ischemic heart disease who delivered between 2010 and 2018 in France were included in the CONCEPTION cohort. Data were extracted from the French National Health Insurance Information System database. Acute coronary syndromes were defined according to the International Classification of Diseases, Tenth Revision codes recorded in the principal hospital diagnosis. We used Poisson regression to estimate crude acute coronary syndrome incidences, and tested age-adjusted Poisson models to compare the incidence risk ratio of acute coronary syndrome between pregnant and nonpregnant women, with 95% confidence intervals. Among 6,298,967 deliveries in France, we observed 225 first-time acute coronary syndrome diagnoses during overall pregnancy (overall pregnancy-related acute coronary syndrome incidence, 4.34/100,000 person-years; 1 case/23,000 pregnancies). In multivariate analysis, independent factors associated with acute coronary syndrome were age, social deprivation, obesity, tobacco use, chronic hypertension, and hypertensive disorders of pregnancy (all P<.05). Among the nonpregnant women aged 15 to 49 years in the general French population, 18,247 cases of acute coronary syndrome (incidence, 16.5/100,000 person-years) occurred throughout the whole study period (>100 million person-years). Compared with the acute coronary syndrome incidence in nonpregnant women, age-adjusted overall pregnancy-related acute coronary syndrome incidence was lower (incidence rate ratio, 0.76; 95% confidence interval, 0.57-0.98; P<.05). Although compared with nonpregnant women, age-adjusted incidence rates were lower during pregnancy, risk was increased during peripartum and postpartum periods. With an incidence of 4.34 per 100,000 person-years, acute coronary syndrome still accounts for a significant proportion of maternal mortality. The peripartum and postpartum periods remain high-risk periods, and greater efforts should be made in terms of acute coronary syndrome prevention, especially because several cardiovascular risk factors are treatable, such as tobacco use and hypertensive disorders of pregnancy.

Points to Consider in the Development and Information Provision of Vaccines for Vaccination during Pregnancy: A Survey.

This report surveyed vaccination decisions during pregnancy based on the package inserts of vaccines approved in Japan, the USA, and Europe. Furthermore, it evaluates vaccination decision-making factors based on the characteristics of the target infections and the modality of the vaccines. Live vaccines known to cause fetal abnormalities are contraindicated for pregnant women, whereas vaccines for life-threatening infectious diseases are authorized for administration during pregnancy when the need is recognized, even for live vaccines. We compared the World Health Organization and European Medicines Agency guidelines on the development of vaccines for pregnant women and surveyed the details of the studies to collect information on SARS-CoV-2 vaccination during pregnancy. In compliance with the guidelines, for all SARS-CoV-2 vaccines, non-clinical reproductive and developmental toxicity studies and clinical trials including non-pregnant women of childbearing age were conducted prior to the vaccination of pregnant women. For all vaccines, information from registries on vaccination during pregnancy are used for post-marketing surveillance. While it is desirable to vaccinate women before pregnancy through planned immunization, whenever possible, pandemics such as H1N1 influenza and COVID-19 may require vaccination even during pregnancy. Necessary and sufficient studies for the decision of vaccination during pregnancy should be carried out promptly.

57 Buprenorphine Initiation for Pregnant Patients With Opioid Use Disorder: A Multicenter Observational Study of California Bridge Sites

57 Buprenorphine Initiation for Pregnant Patients With Opioid Use Disorder: A Multicenter Observational Study of California Bridge Sites

THE EFFECT OF DATE JUICE AND HONEY ON INCREASING HEMOGLOBIN IN PREGNANT WOMEN WITH ANEMIA

Pregnancy is a physiological change in women. There are changes in the body during pregnancy, one of which is in the blood vessel system. These changes make the volume of plasma in the blood increase, this results in dilution of the blood. From these changes, pregnant women are prone to anemia, where the condition of the body lacks blood. Globally, the incidence of anemia reaches 29.9% in women of childbearing age or more than half a billion women aged 15-49 years have anemia. With a prevalence of 29.6% in non-pregnant women of childbearing age and 36.5% in pregnant women of childbearing age. Anemia in pregnancy has several effects such as premature birth and postpartum hemorrhage. So anemia during pregnancy requires serious treatment. There are pharmacological and non-pharmacological treatments for anemia. One of the non-pharmacological treatments that can be done is using dates and honey. Dates and honey contain iron, vitamin C, vitamin B complex and folic acid which are needed in the formation of blood cells. In this case, the researcher conducted a search for evidence of foreign literature traced through electronic media facilities with keyword guidance. There were 6 relevant articles, each of which represented an effect of giving dates and honey in cases of anemia during pregnancy, especially in pregnant women who have anemia.

Urinary phthalate metabolites and phenolics in women of childbearing age and their association with thyroid hormones: a comparison study of fasting status

[BACKGROUND AND AIM] Exposure to parabens and phthalates has been associated with thyroid hormones in humans. Epidemiologic observations, however, are often inconsistent depending on population, probably due to different susceptibility or other factors such as exposure misclassification. Fasting status may influence the urinary levels of many chemicals, especially when their major exposure pathways are related to diet. In the present study, we assessed the associations of urinary phthalate metabolites and phenolics with thyroid hormones in non-pregnant women of child-bearing age in Korea (20-49 years of age), considering fasting status. [METHODS] As a fasting population, we recruited women (n=254) who visited four hospitals after &amp;#x3e;9 hr of fasting between 2015 and 2016. From the fasting women, we measured phthalate metabolites and parabens in urine, and thyroid hormones in serum. Non-pregnant women of the same age group, who were not asked to fast, was chosen from KoNEHS Cycle 3 (2015-2017) (phthalate metabolites (n=341) and phenolics (n=340)). [RESULTS] Urinary concentrations of MEHHP, MEOHP, MBzP, and BPA were &amp;#x3e;2 folds higher in the non-fasting women, and those of MeP were higher in the fasting women. Regardless of fasting status, MeP and EtP levels showed significant negative association with both total and free T4. DEHP metabolites also showed negative associations with free T4 but positive associations with total T3. However, associations of MBzP and BPA with thyroid hormones varied by the fasting status, which might be due to the influence of diet on their urinary concentrations. [CONCLUSION] While certain chemicals like EtP and to lesser extent DEHP are known to be delivered through dietary factors, consistent associations with altered thyroid hormones regardless of fasting status are noteworthy. [KEYWORDS] thyroid hormones; fasting; phthalates; phenolics [Acknowledgement] This work was supported by grants from National Research Foundation of Korea (NRF) (NRF-2020R1A2C3011269 and NRF-2022R1C1C2006982).

Cerebrospinal fluid and arterial acid–base equilibria in spontaneously breathing third-trimester pregnant women

BackgroundAcid–base status in full-term pregnant women is characterised by hypocapnic alkalosis. Whether this respiratory alkalosis is primary or consequent to changes in CSF electrolytes is not clear. MethodsWe enrolled third-trimester pregnant women (pregnant group) and healthy, non-pregnant women of childbearing age (controls) undergoing spinal anaesthesia for Caesarean delivery and elective surgery, respectively. Electrolytes, strong ion difference (SID), partial pressure of carbon dioxide (PaCO2), and pH were measured in simultaneously collected CSF and arterial blood samples. ResultsAll pregnant women (20) were hypocapnic, whilst only four (30%) of the controls (13) had an arterial PaCO2 <4.7 kPa (P<0.001). The incidence of hypocapnic alkalosis was higher in the pregnant group (65% vs 8%; P=0.001). The CSF-to-plasma Pco2 difference was significantly higher in pregnant women (1.5 [0.3] vs 1.0 [0.4] kPa; P<0.001), mainly because of a decrease in arterial Pco2 (3.9 [0.3] vs 4.9 [0.5] kPa; P<0.001). Similarly, the CSF-to-plasma difference in SID was less negative in pregnant women (–7.8 [1.4] vs –11.4 [2.3] mM; P<0.001), mainly because of a decreased arterial SID (31.5 [1.2] vs 36.1 [1.9] mM; P<0.001). The major determinant of the reduced plasma SID of pregnant women was a relative increase in plasma chloride compared with sodium. ConclusionsPrimary hypocapnic alkalosis characterises third-trimester pregnant women leading to chronic acid–base adaptations of CSF and plasma. The compensatory SID reduction, mainly sustained by an increase in chloride concentration, is more pronounced in plasma than in CSF, as the decrease in Pco2 is more marked in this compartment. Clinical trial registrationNCT03496311.